Active NPI
Colleen Casey Mattioli, MS, OTR/L
- Occupational Therapist
- Charlotte, NC
National Provider Identifier
1336630243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 11622
- Practice address
- 6000 Park South Dr
Charlotte, NC 28210-3298 - Phone
- (704) 643-1400
- NPI assigned
- May 25, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 11622 | NC | Primary |
Addresses
Primary practice location
6000 Park South Dr
Charlotte, NC 28210-3298
Mailing address
13606 Strathaven Dr
Matthews, NC 28105-4093
Phone (585) 746-6415
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1527206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1527206400000",
"number": "1336630243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13606 STRATHAVEN DR",
"city": "MATTHEWS",
"state": "NC",
"postal_code": "281054093",
"telephone_number": "585-746-6415"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6000 PARK SOUTH DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282103298",
"telephone_number": "704-643-1400"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATTIOLI",
"first_name": "COLLEEN",
"middle_name": "CASEY",
"credential": "MS, OTR/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-05-25",
"last_updated": "2018-05-25",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "NC",
"license": "11622",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.